High-risk Eye and Limb Preservation Program (HELPP)

Last updated 2024-05-01T12:01:16Z

HELPP increases access to podiatry basic foot care services for patients who are at increased risk for amputation by embedding intermediate care technicians (ICTs) into rural VA clinics. This reduces the travel burden for patients who are rurally located and ensures consistent, routine podiatry care. Because ICTs are versatile, other health care components are built into these patient visits, including assessment for diabetic footwear and eye screening, making this a convenient, one-stop shop for Veterans.

Origin:

August 2020, Atlanta VA Medical Center (Atlanta, Georgia)

Adoptions:

1 successful

Awards and Recognition:

2024 VHA Innovation Ecosystem Entrepreneur in Residence Fellowship

Overview

The problem

Many rural and highly rural Veteran patients who are at increased risk of lower limb amputation don’t have access to podiatry services. Basic foot care services (nail and callus cutting) are a critical, preventative care that patients need to maintain good foot health. In the absence of this service, nails become overgrown and calluses will cause excess pres ... Many rural and highly rural Veteran patients who are at increased risk of lower limb amputation don’t have access to podiatry services. Basic foot care services (nail and callus cutting) are a critical, preventative care that patients need to maintain good foot health. In the absence of this service, nails become overgrown and calluses will cause excess pressure to underlying soft tissue, resulting in open wounds. Poor foot health increases the risk of diabetic foot ulcerations, foot infections and lower extremity amputation. The same patients who are at risk for amputation are also at risk for blindness. See more

Images

Above:

An Intermediate Care Technician (ICT) provides routine foot care to a Veteran enrolled in HELPP

The solution

The High-risk Eye and Limb Preservation Program (HELPP) deploys intermediate care technicians (ICTs) to rural areas to provide basic foot care services (nail cutting and callus cutting) and eye screenings to Veteran patients who are geographically rural or highly rural. This is done using virtual care, where a remote podiatrist observes the visits supervises ... The High-risk Eye and Limb Preservation Program (HELPP) deploys intermediate care technicians (ICTs) to rural areas to provide basic foot care services (nail cutting and callus cutting) and eye screenings to Veteran patients who are geographically rural or highly rural. This is done using virtual care, where a remote podiatrist observes the visits supervises the care delivered by the ICT, addresses patient concerns, prescribes diabetic footwear and any necessary medications. The ICTs can also be trained to perform the eye screen and measure for diabetic footwear at this time visit. Now patients receive just in time care at a VA location much closer to their residence. See more

Images

Above:

ICT providing routine footcare for Veterans

The results

Since 2020, HELPP has improved the amputation ratios by more than 40%, decreased community care utilization by more than 60% and improved access to care. Wait times at the main facility in Atlanta have decreased from 38 days to 10 days.

Diffusion tracker

Does not include Clinical Resource Hubs (CRH)

GA: Atlanta VA Medical Center (Atlanta, Georgia)

There are no in-progress adoptions for this innovation.

There are no unsuccessful adoptions for this innovation.

Implementation

Departments

Podiatry

Core Resources

Resource type	Resource description
PEOPLE	Podiatrist 2 Intermediate Care Technicians (ICTs) per Podiatrist
PROCESSES	Training for ICTs in basic foot care (nail and callus care, basic wound care), diabetic shoe measuring and eye screening, competencies are defined both by TMS #28493 and National ICT program
TOOLS	Salary and supervisory management for ICTs and Podiatrists Post and selection of podiatrists/ICTs Disposable instrumentation Administrative Support: working with local staff to build clinics, create consult templates and complete the Telehealth service agreements (TSA), clinic cancelations, OPPE and performance evaluations of providers, etc. Telehealth equipment (CAS cart or webcam with extender)

Contact

Comment

Comments and replies are disabled for retired innovations and non-VA users.

VA User (Registered Nurse) posted 2024-04-02T22:19:27Z

I am hoping this will soon be adopted in our VISN.

VA User (Certified Registered Nurse Anesthetist, RICVAMC) posted 2024-04-02T13:44:40Z

Great work! Keep plugging away, good things take time!!

Email

Email nichol.salvo2@va.gov with questions about this innovation.

About

Original team

Nichol Salvo

Chief, Podiatry Section

Sherrill Murad, DPM

Assistant Chief, Podiatry

April Maa, MD

Clinical Director for Technology-based Eye Care Services

Brian Telles

Intermediate Care Technician

Marcia Moodie, RN

Associate Chief Nurse

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High-risk Eye and Limb Preservation Program (HELPP)

Origin:

Adoptions:

Awards and Recognition:

CATEGORIES:

Overview

The problem

Images

Above:

The solution

Images

Above:

The results

Diffusion tracker

Successful adoption (1)

In-progress adoptions (0)

Unsuccessful adoptions (0)

Implementation

Departments

Core Resources

PEOPLE

PROCESSES

TOOLS

Contact

Comment

Email

About

Original team

Search categories